Bullying among nurses needs to stop

I do not wish simply to use the buzz word of the hour. Nor do I wish to assert that I have all the answers.

I genuinely desire to bring to light an interesting conflict that has plagued the nursing profession for decades.

Bullying.

Why in a profession centered around the concepts of compassion, caring, and healing has a mindset of bullying permeated the culture. Even more confusing is that most often, this bullying is a “lateral aggression,” not one of superior to subordinate.

We have all heard the phrase “nurses eat their own.” Most of us have experienced it.

An older coworker of mine once told me of a time when she was a young nurse. The more experienced nurses literally made them sit on the floor during handoff reports.

This is an extreme example, but I think this thinking still exists even if we are not forcing new nurses to physically sit on the floor.

There have been no major studies in the United States regarding the bullying issue in the nursing profession.

Interestingly enough, as of January 1, 2009, the Joint Commission requires a process in place for handling intimidating behavior among nurses.

Obviously, this bullying is known in the healthcare world, but no one seems to be talking about it.

Is it because nursing came about as a female dominated profession in the midst of a male dominated society? Females possibly feel the need to be aggressive in a business sense much like men. Nurses feel they need to hold on to what they have or it may be taken out from under them.

Possibly: Younger nurses will never know what older nurses went through. Young ones have it so easy and can never understand what we, as older nurses, went through for them to be where they are. They will never know what I know.

A few studies have been conducted abroad, mainly in Europe, regarding this phenomenon. Most agree that about 50% of nurses admit to have been bullied by other nurses.

Whatever the reason, we need to put aside our selfish ambitions and get back to the root of the profession.

We need to fix this.

Sarah Beth Cowherd is a nurse who blogs at SaraBethRN.com.

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  • http://www.wjhb.de William

    I suspect that bullying among nurses is closely related to their social status and income, their degree of confidence or lack it, the atmosphere on hospital wards created by supervisors, and relationships between doctors and nurses. Who gets hired is also important. I doubt if someone becomes a bully when they start work.

    Otherwise I still think that all nurses would be better off if they were involved in martial arts or boxing, even if only for a year or so, designed to boost their self-confidence. I am also in favour of their use of gutter jokes, slang and even filthy language if necessary to establish a sort of “loose-canon” identity that will keep the bullies at bay. They might even pay a doorman to pick them up from work now and then – very visibly – big, muscular and looking unpredictable and struggling to be friendly. (“It’s kind of scary the way he always loses his self-control when he sees me sad.”)

  • jsmith

    It’s a female thing. Schoolgirls are absolutely terrible to each other. This is well known. With males, things are different, more likely to be physical. This has limited consequences on the schoolyard, but potentially catastrophic consequences among adult males. All men know this (although, curiously, most women I have talked to about this have no clue of this particular male-male interaction), so we usually give each other a wider berth.

  • Bob

    “Younger nurses will never know what older nurses went through. Young ones have it so easy and can never understand what we, as older nurses, went through for them to be where they are. They will never know what I know.”

    This is the type of self serving garbage that perpetuates this distinction of “old school vs new school nursing” and may even foster this bullying environment. Comments like these do nothing to be part of the solution. Everyones on the same team with the same level of licensure [in the nursing example]. Yes, some people took different roads, some earlier, some later, but we all should be going to work everyday doing our best for the patients. The medical field in general has this “It was like this for me so you must also be subjected to it”. Hopefully we can grow out of this archaic philosophy and embrace change we desperately need.

  • Kat

    I have been in health care for 20+ years. Bullying does exist. It’s a pecking order of sort, who has what degree, what college, which certification ect. There is a competitive nature with female nurses and perhaps this is one of the traits that draw us to this profession. We are not all here because we “like to help people”. Each of us has our own agenda for going into nursing; however this profession is sought out by people with similar personalities. Strong, candid, smart, driven workers! It’s almost a competition on the floor who knows more and who has done what. There is more “one upping” in nursing than any other profession out there! We are like a swim team…we are all on one team, but individually recognized and we compete against our own team mates. I left patient care for awhile because I couldn’t take the caddie nit-picky bitching for 80 hours a week. I tend to be a peacekeeper in the group and I chose nursing because it suits my ADHD and my desire to always be in a learning curve. I am friends with all and all talk behind my back. It’s a group of 12 year olds, a slumber party with mean girls ect… I guess I am used to it and Teflon against the mean ones! I am not one of them, but I can pick out the problem causing nurses in seconds. I now work at the VA (I won’t say which one) and we have many more male nurses than I have ever worked with in the past. The female bitching still continues however the men temper the group. They really don’t carry on like female nurses. This may not be popular with the other nurses in my gender group. By my 20+ years of observations the more male nurses you work with….the better and more fulfilling your job will be. Male nurses are not perfect however they tend to walk away and ignore the caddie BS…which simply should embarrass the trouble causing nurses and cuts the crap in half. C’mon guys keep nursing……you bring quality to a work place!

  • Karen

    As someone who has worked in hospital/physician offices for over 15 years, I am well aware of the bullying atmosphere brought about by some nursing staff. Sometimes I feel it is like the child who yells at a pet because he/she has no way to respond to being yelled at by parents. Nurses bear the brunt of intimidation and frustration from doctors and I feel they are taking it out on their coworkers. I seldom see them taking it out on patients, although this does probably happen as well. As a healthcare business professional, I wonder why those who care so deeply about the human condition can be so uncaring in their day to day interactions.

  • Molly Ciliberti, RN

    After 20 years in ICU/CCU and brief stints in ED and PAR units, I have not experience any bullying on the swing and night shifts. The day shift were all super nurses and they did a lot of complaining (and they had all the support they could possibly get during the day vs. the slimmed down support on evenings and nights) and we just ignored it. Instead I found great camaraderie between the nurses on these two shifts; we helped each other and worked together to benefit our patients and each other. It made even difficult nights work since we were in it together.

  • Suzy

    I think bullying starts in nursing school as I had several instructors who were proficient in bullying. I was an older student and some of them were either intimidated or just plain mean. I have always had self confidence but 4 years of being put down and degraded did a number on my self esteem. When I got out I tried to make a point of being nice to new nurses and showing them the ropes. Now that I have been out of school for 16 years I now see intimidation against “older” nurses. Why can’t we all just work together for the good of our patients?

    • http://www.wjhb.de William

      Another way of questionning the current situation is: How does a moderate degree of competition – always present in human groups – get completely out of hand in the form of bullies and victims. There are no shortage of studies of power relationships in groups, nor is there a lack of consultants and facilitators who can provide assistance in conflict resolution. Assuming your question relates to your own professional environment, the question you pose at the end of your comment requires an answer which only you (with or without your colleagues) can answer, preferably with the help of a knowledgeable, trustworthy adviser. The question is good. But this is no place to deal with it.

  • Kat

    I guess the way I look at things with the bullying is it will always be there….to what degree is the problem. Each and every nursing floor I have ever worked on has at least one bully or pair that gang together and usually are the “tattlers” or “minions” of the manager. The manager accepts this and even embraces these people…as they are the eyes and ears of the unit… telling any little discretion. The bully usually stops on individuals once they are called out in front of a group. Example: The bully nurse challenged the integrity of the relief nurse …on a taped report. The relief nurse, a male with little experience but a lot of confidence (he used to be a cop) politely and professionally confronted the bully at the next report they were both in. The relief nurse comments how the bully nurse has never bugged him again.
    Bully’s are like the kids on the playground. They can’t get their control at home or feel the need to impress others by attacking people….it’s a disorder of sort. For some reason the people who bully are attracted to nursing. Let’s face it, the job holds little glamour but there are many opportunities to be a star. Last night…I was a star…helped a very sick individual and he thinks I am the best thing since sliced bread. I sometimes toot my own horn to my significant other…but mostly, it makes me feel good to have a person feel helped by me. Nursing takes talent and it takes a variety of personalities to make a good group or team. Many patients relate to the bully’s. The bully’s I have worked with..well, for the most part…they are great nurses. They dare not do anything wrong as they know the entire unit will know and they will topple from their self imposed pedestal. Bullying will always be there and in a way a mild bit of competition and pushing helps people grow professionally. Competition drives people to do better and achieve. There simply doesn’t have to be unprofessional, attacking, fabricating and hurtful tactics being used. It’s the leaders of the team who need to identify this.However, most of the leaders were probably bully’s in their own time.
    Our Queen Bully had a work party a few weeks back…6 out of 70 showed up…this should say something to her. My little motto to live by: If one person tells you “you have a tail” no big deal… if two people tell you “you have a tail” …you may want to look. Tell your bully’s at work they have a tail, and if they pick on you…be strong, be a prudent nurse and if necessary confront them on their words and actions, in front of a group, (never alone). Bully’s can’t handle public humiliation……so do it once and this Big Bad Bully nurse will never be a problem for you again.
    Take care and happy no bully weekend!

  • Al

    New Nurse: I don’t want to work holidays, weekends, or nights. Oh.. I also got into the profession for the money. I don’t care if my lack of humility is disrespectful, it’s all about me.

    Old Nurse: Do I defend my profession at risk of being called a bully?

    Learn these words and say them to your bully: “did I do something to offend you or are you intentionally being rude to me?” If they respond in the latter, then stand up and stop being over sensitive!

    • http://www.wjhb.de William

      Old Nurse: Identifying with a profession is not a good idea. The reasons why are hopefully apparent. What counts is how well collaboration works. New Nurse’s philosophy is her problem.

      New Nurse: Money is great. Spend one half of your life half-dead earning money to live during the other half of your life and you die having lived one-half of your life. You don’t even get to live once.

  • Bob

    flo nightengale once said “nursing is part of a higher calling”, shame on you if you think it is erroneous if older nurses hold this as their creed.

    Communication sure sounds nice, all the communication in the world wont weed out bad, selfish, or wrong intentions. If your skin is that thin, then maybe your in the wrong line of work.

    • http://www.wjhb.de William

      No reason for shame to think that someone else is in error.

      A “calling” to provide care has nothing to do with an individual’s identification with nursing as a profession. And it need not have anything to do with a creed (statement of belief). A calling can do without both creed and profession because the response is the deed, in this case providing medical care.

      Leave weeding to the garderners. This image is dead. Resolving conflicts on the ward, whatever their cause, does indeed require communication skills and, where necessary, conflict resolution mediators.

      I interpret your last line to mean that you impute to your addressee an abnormal degree of sensitivity. Assuming that you do not know this person at all, I would suggest this is a lot of hot air.

      By using the word “work” at the end you are undermining your first statement about “higher calling”. When we are passionately involved in a calling we do not work. Did she enter a profession or respond to a calling? I doubt if you know the answer to that question.

      You seem to be on first name terms with Florence Nightingale. Unlike your addressee, however, she’s dead.

  • Kat

    This isn’t an old nurse/new nurse issue. The two bullies’ I work with have less than 6 years experience put together. These two most likely live their entire lives attempting to make relationships by intimidating and control tactics. The truth is you are a professional with integrity or not. A person with integrity doesn’t judge someone; rather a person with integrity looks to their own actions and reactions first and then attempts to find a path to resolve conflict with no compromise to their integrity. A professional with integrity understands the learning curve of a novice nurse and should find the humor in a nurse who does not want to work weekends and holidays. You as a veteran nurse are as liable as the new grad that left his or her preceptors wings just yesterday. Veteran nurse offer your experience and assistance to the nurse who still has his/her knees, back and feet functioning without pain… Perhaps your experience and his/her stellar physical abilities could complement one another?

    This isn’t an experience thing…this is a personality thing! Some people are bully’s and they act this way because of their own insecurities, perceived failures and shortcomings. Stop blaming a novice nurse who doesn’t understand the weekend and holiday schedule….for your personality flaws….. Check your integrity and choose who you want to be…
    Do you want to be bitter and judgmental or do you want to be a compassionate leader?

    Bully’s sweep off your doorsteps….you’ll be a happier individual in and outside of your professional life.

    • http://www.wjhb.de William

      I interpret your of the words “judge” and “judgemental” to mean “judge in a manner which I find disagreeable”. We are all judging all of the time. It is probably not possible to express anything in words without judging. I rather doubt if it has much to do with integrity all.

      Regarding experience. Not all experience is valuable in a practical sense. At least some of it is historical and has its proper place in museums, memoirs and history books. Nothing against museums, memoirs and history books. But it is not the all-purpose weapon of choice to use against the novice that some may think it is.

      What is left out of this discussion is the role of the “human resources” department in the selection of staff and the responsibility of supervisors for the atmosphere in the hospital or clinic. This should be the reason why supervisory positions get paid well, because their employees feel well under their leadership. And even the chronic complainers can laugh.

  • Kat

    Arguing semantics? Is this really the level you want to bring this discussion to? Fortunate the effort isn’t lost on all as many can read this for entertainment and insight; perhaps even see how a discussion can digress when opinions collide.

    The point is that all new nurses don’t have a chip on their shoulder and make demands which degrade the profession and all old nurses are not holding the torch by firmly demanding respect for their time served on holidays and Saturday night shifts. The point is that regardless of our stages in practice it is a person’s integrity or lack of which drives this conflict.

    Human Resources (Talent Management) are great and utilized, however it still isn’t the cure for human nature and behaviors which embrace conflict. At some point the bully’s can be ignored and there is a simple understanding when a conflict arises and it’s the same people over and over again with petty, erroneous or childish tactics driving the issue, well it’s basically shrugged off by all, including managers and HR. There are something’s even almighty HR can’t change which is the bitter and unprofessional tactics that some bully’s probably have used their entire life. HR can’t make people happy and compassionate…this comes from within.

    A bully has to recognize their own issues first ….but the nature of a bully, this simply won’t happen as there is too much false pride invested in their abilities. Again, to all the nurses who have integrity, compassion and a complete inability to understand why this bully’s act the way they do: don’t give these nurses any more space in your head, just be accountable for yourself, be strong, anticipate the bully’s next move and speak openly about their hostility in the workplace. You will never change the bully’s mentality until the bully does an internal audit of their own behavior.

    One more note to the Old Nurse: The veteran nurse and the New Grad probably chose nursing for different reasons. If you went to nursing school 25 years ago the scope of practice and spectrum of career opportunities offered are much different than they are now. Our profession has grown and we thank all nurses for elevating us to the level of education and practice which is now available. Some new nurses came into the profession because of the flexibility offered in nursing. Indeed there are many positions in this field where nights and weekends are not mandatory. Because you, old nurse, chose to commit yourself to direct patient care your entire career does not make you any better than a nurse who makes the choice to commit their career to areas where a Monday- Friday schedule is the norm. I personally like working nights, weekends and holidays so to generalize that all new nurses are not willing to pay their dues, is simply a statement from a person who regrets the choices they have made in their own career.

  • http://www.wjhb.de William

    One can understand “arguing semantics” to mean that two people are finding their way to a common language enabling them to get on with their dialogue. In that sense you are right.

    When supervisors trivialise subordinates’ concerns they automatically delegate power to others – for example to those perceived as having “senority” or, in this case, to bullies. It is in the interest of anyone high up in the informal chain of command that the real power they exercise be seen as involving “trivial matters” too unimportant for formal consideration. These trivial matters, however, give bullies frequent opportunities to wield power and humiliate their victims. This unspoken delegation of authority to lower ranking staff alongside a blindness to nasty little tyrants is one sign of irresponsible management.

    Another sign of poor management in healthcare is the inability to recognise the malady known as “seriosity”, familiar to some as “sermonizing”. Many of us are struck by this illness as we get older. We seem to become susceptible to frowning and using words like “must” and “should” a lot. Light-heartedness then appears to be the enemy of the “good”. It is vital for supervisory staff to recognise and laugh at seriosity and promote light-heartedness.

    It is my conviction that highly skilled and knowledgeable professionals need light-hearted laughter frequently to remain motivated and focused. I believe that in an atmosphere deprived of the oxygen of laughter bullies thrive like anaerobic bacteria. Here is something for your staff washroom: Moralizing morons murder motivation.

    Perhaps the inability to laugh, especially at oneself; should be grounds for dismissal. :)

  • Kat

    William~
    Thank you for the welcome break. I have been writing a paper on the ERISA enactment of 1974. The convoluted laws have now parched my brain of everything but humor.
    I appreciate your definition of semantics and will use it with future conversations, as we are now closer together in the bully topic. What I have surmised is you and I both agree humor is a necessity! People outside the walls of heath care as a profession may not understand this. Those of us who have stood in a hospital hallway at 2am wondering how we got to this place and seeing what we are seeing (at that very moment) all need to scratch our heads at our career choice, laugh and move to the next priority task.
    I am really attempting to say that trying to figure out why one nurse is a bully and why they were drawn to a profession which is to be embodied with compassion for our fellow man…is wasted space in our heads. We will never know why nursing attracts bullies and why it seems to never be remedied. I work for the government and we have programs in abundance for mediation, personal therapies, talent management and education. Supervisors are highly educated and there is never a lack of competencies to complete…but the problems still exist.
    In the real world we only have so much time in a day and this time has to be divided between numerous obligations. So I chose to pick my battles. One battle that I encourage other nurses to ignore is how to fix the bully. It’s as simple as bringing objective information to management and being strong in your practice and person. That’s it. Be accountable to yourself and don’t let the bully win. The Bully wins when you give them space in your day and your head. If management can’t cure the issue…well surly I can’t either. The only interfering difference with this is if I have a personal relationship with a co-worker. Well the remedy to this is to maintain a rule where you don’t socialize with co-workers. I have no loss of relationships and I stay out of the drama that occurs with a close knit work group. Face it …nurses talk about things that others wouldn’t dare approach, and this leave some sort of open door to dig into the actions of co-workers as a form of entertainment for a bully.
    I simply have an easy plan to follow. 1) Present your information to management 2) expose the bully to co-workers in a professional open forum 3) walk away and make sure I do my job, care for my patients and remain accountable for my actions.
    Thanks again William, back to ERISA…. Perhaps we can discuss topics again, as I appreciate your knowledge, wisdom and candor.
    ~Katrina